Information

  • Date

  • Inspection completed by

  • Location
  • Is the AED unit located in its designated area? Identify serial number of unit below.

  • Is the AED unit clean, undamaged and if applicable in its carry case or cabinet?

  • Is the AED rescue kit present and either stored on the carry case or cabinet or attached to the AED unit?

  • Does the AED rescue kit include: gloves, prep razor, scissors, towel, moist towelettes, CPR mask?

  • Are all batteries within the expiration date? (01/12/2025)

  • Are the PADS within the expiration date? (01/2026)

  • Does alarm on AED cabinet in working order? Note: Batteries should be replaced annually.

  • Is the Status Indicator showing a green check mark or the word 'OK'?

  • Are the electrodes attached to the unit?

  • Are you re-installing new electrodes or batteries?

  • If re-installing new electrodes or batteries, did you turn unit on to allow it to complete a full self-test to confirm a visible green check mark?

Additional Photos

  • Picture of unit

  • Add media

Signature

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.